A client with type 2 diabetes takes 10 units of Insulin glargine each evening at 2300. She asks the home care nurse on call if she should take her dose this evening because she has had a fever to 101.2 F (38.4 C). diarrhea & "can't hold anything on my stomach." since yesterday The nurse replies

Yes, take it. There's a risk you could develop dangerously high blood sugar because of your fever.

No, do not take it this evening. You could get hypoglycemic before this morning.

Yes, take the dose. Check your blood glucose in the evening & the morning when you wake up.

No, do not take your dose. You must set an alarm & check your glucose level every 4 hours.

Answer and Explanation

The Correct Answer is A

A. Yes, take it. There's a risk you could develop dangerously high blood sugar because of your fever: Even though the client is experiencing fever and diarrhea, these conditions can cause stress on the body, which in turn can increase blood sugar levels. Fever and illness often result in elevated blood sugar levels due to the body's release of stress hormones like cortisol and adrenaline, which raise blood glucose. Therefore, the nurse should advise the client to take their insulin to prevent hyperglycemia. The nurse should also recommend the client to monitor their blood glucose more frequently during illness.

B. No, do not take it this evening. You could get hypoglycemic before this morning: Insulin glargine is a long-acting basal insulin, and it does not cause rapid or quick peaks in blood sugar levels. It is unlikely to cause hypoglycemia unless the client does not eat or is taking excessive doses. It is more important to control potential hyperglycemia during illness.

C. Yes, take the dose. Check your blood glucose in the evening & the morning when you wake up: The client should take their insulin, but the nurse should also suggest more frequent blood glucose checks, especially every 4 hours, rather than just evening and morning checks. Illness and fever can cause fluctuations in blood sugar, so more monitoring is necessary.

D. No, do not take your dose. You must set an alarm & check your glucose level every 4 hours: The client should continue taking their insulin to manage blood glucose levels, especially during illness, to prevent hyperglycemia. Checking blood glucose every 4 hours is important, but withholding insulin could worsen the situation by increasing the risk of hyperglycemia.

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Correct Answer is A

Explanation

A. NSTEMI (Non-ST-Elevation Myocardial Infarction) refers to a heart attack where there is partial blockage or damage to the heart muscle but less severe than in STEMI (ST-Elevation Myocardial Infarction). The damage in NSTEMI typically affects a smaller area of the heart muscle, and it may not involve a full-thickness injury like in STEMI. This response provides the client with a clear, understandable explanation of their condition.

B. This statement is incorrect because NSTEMI is not the same as angina. Angina is chest pain due to temporary lack of blood flow to the heart, while NSTEMI involves actual damage to the heart muscle due to a more significant reduction in blood flow, even if the heart attack is less severe than a STEMI.

C. While NSTEMI is a serious condition, it does not automatically require open heart surgery. Treatment often involves medications (like antiplatelets or anticoagulants) and procedures like angioplasty or stenting to address the blockage, not necessarily surgery.

D. This response is somewhat misleading. Cardiac catheterization may be used to assess the severity and location of the blockage, but it is not always used to directly correct the problem. Procedures such as angioplasty or stent placement may follow the catheterization, but not all patients with NSTEMI will need immediate intervention.

A. Administering aggressive medical interventions to prolong life. B. Encouraging the patient to engage in physical therapy and exercise. C. Providing comfort care and managing symptoms according to patient's wishes. D. Providing respite care and support for the patient's family.

Correct Answer is C

Explanation

A. Administering aggressive medical interventions to prolong life: In the end stages of Huntington's Disease, aggressive medical interventions are generally not the priority. Huntington's is a progressive neurodegenerative disease, and prolonging life without regard to the patient's quality of life is usually not the focus. The emphasis in end-of-life care is on comfort and symptom management rather than aggressive treatments.

B. Encouraging the patient to engage in physical therapy and exercise: While physical therapy can be important earlier in the disease progression to help maintain function and mobility, in the end stages of Huntington's Disease, the patient's focus is more on comfort care. At this point, physical therapy may not be practical or helpful in improving quality of life, so it is not the primary consideration.

C. Providing comfort care and managing symptoms according to patient's wishes: This is correct. The most important consideration in end-of-life care for a patient with Huntington's Disease is to focus on comfort and symptom management. This includes addressing pain, managing emotional and psychological symptoms, and ensuring that care aligns with the patient's wishes, values, and goals. End-of-life care should prioritize maintaining dignity and ensuring the patient's comfort.

D. Providing respite care and support for the patient's family: While providing respite care and family support are very important aspects of caregiving, the most important consideration is the patient's comfort and managing symptoms in alignment with their wishes. Respite care for the family is important but is not the central focus of end-of-life care for the patient.

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A client with type 2 diabetes takes 10 units of Insulin glargine each evening at 2300. She asks the home care nurse on call if she should take her dose this evening because she has had a fever to 101.2 F (38.4 C). diarrhea & "can't hold anything on my stomach." since yesterday The nurse replies

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Naxlex Comprehensive Predictor Exams

The client tells the nurse, "My physician told me that I had an NSTEMI. I thought all heart attacks were the same. Can you explain this to me?" What would be the nurse's best response?

Correct Answer is A

Explanation

Which of the following is the most important consideration in end-of-life care for a patient diagnosed with Huntington's Disease?

Correct Answer is C

Explanation

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